Background Gestational Diabetes Mellitus (GDM), once thought to be fully reversed after pregnancy, is now a firmly established independent risk factor for Type 2 Diabetes Mellitus (T2DM), cardiovascular disease and other chronic conditions. Given the high levels of risk, low-cost and scalable pharmacological preventive approaches may prove an effective tool for prevention of GDM. While there is strong rationale for preventive strategies focused on behavioural modification in women with prior GDM, the early years after pregnancy present unique challenges to mothers. Aims This study will: Measure prevalence and identify predictors of persisting abnormal blood sugar levels (dysglycaemia) among women with recent GDM. Identify women’s views and the views of their healthcare providers on the long-term risks of T2DM. Examine the feasibility of a randomised controlled trial of preventive drug therapies, in addition to lifestyle interventions, among this population. Method One

Background Most people in low and middle-income countries (LMICs) such as India cannot access quality healthcare. A paucity of healthcare workers, particularly specialist physicians, is one of the main reasons. Task-sharing approaches in LMICs were recently reviewed and found to be a viable option to improve disease outcomes while also leading to capacity building and cost savings. Epilepsy, one of the commonest neurological disorders, affects 50 million people worldwide, of whom, a fifth live in India. It accounts for 14 million disability-adjusted life years and 1,26,000 deaths worldwide each year. The treatment gap is high, almost 50-80% in India. A professional resource gap is one of the important reasons for the treatment gap. There is a lack of specialists to manage epilepsy across the country. Our previous study points towards an unmet need for a comprehensive approach towards epilepsy care in the community, which should essentially include capacity building among care providers, raising commu

BackgroundThe Scheduled Tribe (ST) population is a marginalised community in India and has greater vulnerability to mental health issues for multiple reasons, including the impact of rapid social changes altering their lifestyles, beliefs and community living; the strain of acculturation when moving to urban spaces; and the use of alcohol and other substances.Our pilot study among ST communities in Andra Pradesh, where they constitute about 7% of the population, found a lack of mental health awareness and limited mental health care facilities.A more sustainable model involving the community and empowering members to act as change agents to enhance mental health facilities is needed to bring about sustainable improvements in mental health and wellbeing. AimsTo address selected social determinants of mental health to promote mental health and well-being among ST communities over three years by building the capacities of community members to act as lay counsellors and strengthening the capacity of the publi

Background Racism has been clearly identified as a determinant of health and wellbeing for Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander people continue to experience racism and discrimination within the Australian healthcare system. Racism is causing dire health consequences and inhibiting access to quality and safe healthcare services.  Aims To comprehensively understand and address the complex dynamics of racism, bias and colonisation in reforming hospital care for Aboriginal and Torres Strait Islander people and families. Methods Decolonise existing tools such as the Readiness to Change Assessment (RCTA) and Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Evaluate health organisations’ readiness to change beliefs, attitudes and processes that maintain inequity. Undertake Aboriginal patient journey mapping and review governance structures, workforce development, current quality indicators and processes f

Every year, an estimated 350,000 children and adolescents are killed in road traffic crashes (RTCs) or by the effects of urban outdoor air pollution, to which road traffic is a significant contributor. RTCs are the leading cause of death for children and adolescents worldwide but those in resource-limited settings are disproportionately affected with 93% of child road traffic deaths occurring in low- and middle-income countries. In addition to the deaths, injuries and disabilities caused by road collisions, children in urban areas often also sustain insidious damage to their developing lungs and brains by breathing traffic-related air pollutants (TRAP). TRAP exposure can result in growth stunting, delays in cognitive development  and chronic respiratory problems. Due to the many overlapping causal factors linking road safety and personal air pollution exposure, there are significant opportunities for complementary mitigation measures to drive improvements in child health, safety, and wellbeing. In

Background Currently, there is a strong ‘Food is Medicine’ movement evolving, calling for healthy foods or meals to be prescribed by doctors to prevent or treat diet-sensitive conditions, like they already do with drugs. Outcomes from early studies, in which doctors prescribe healthy foods, termed ‘produce prescriptions’, have suggested comparable health benefits to prescription medications. In addition to improving health outcomes, these programs also reduce health inequity by focusing on communities experiencing food insecurity. Unhealthy diet is one of the major drivers of type 2 diabetes that costs Australian healthcare tens of billions of dollars each year and occurring most frequently among the most disadvantaged communities. Our completed pilot study in Australia demonstrated considerable potential benefit of produce prescription for those with type 2 diabetes, and high acceptability among program participants. However, gold-standard randomised trial data are needed to define clinica

Background Evidence-based medicine is informed by randomised control trials (RCT) and systematic reviews. Outcomes chosen in these research methods are important in determining if interventions are effective and safe. Research outcomes chosen based on previous research or stakeholder opinions tend to be inconsistent across studies. This variability and lack in consistency makes it difficult to pool data to inform healthcare practice and policy. Core outcome sets (COS) are consensus-derived, standardised sets of outcomes that should be minimally measured in trials on a specific health condition or disease. Using COS enhances the ability to identify meaningful comparisons across research and examine the benefits or harms of interventions. However, COS usage still varies widely across areas of healthcare research. Only 2% of reviewed late-phase clinical trials published 2019-2020 reported using a COS, and just 65% of trialists surveyed in 2021 were familiar with COS. Understanding the current awareness